Presence of depression in diabetic patients is the most important factor leading to erectile dysfunction in such patients.

An India cum US study published in the Journal of Urology found that depression and erectile dysfunction are related to each other in the form of a vicious cycle. Depression instigates erectile dysfunction and erectile dysfunction perpetuates the symptoms of depression.

India is the diabetic capital of the world and both the incidence and prevalence of diabetes are increasing day by day.

It is, therefore, important for the family physician to look for presence of depression in patients with diabetes.

Diabetic patients who complain of erectile dysfunction in the study also have a higher prevalence of high blood pressure and cholesterol abnormalities. These patients were also of older age with uncontrolled diabetes, history of smoking and longer duration of diabetes.

It was also shown that patients who develop erectile dysfunction also had diabetes, eye disorders, neuropathy and peripheral vascular disease.

Effective control of diabetes may reduce both depressive symptoms and erectile dysfunctions in such cases.

News Around The Globe

Statin therapy in men and women does not protect against the risk of fracture, suggested a prespecified analysis of the JUPITER study. Researchers also noted that patients with higher baseline high-sensitivity C-reactive protein (hs-CRP) levels, indicative of systemic inflammation, did not have a higher risk of fracture than those with lower hs-CRP levels. The findings are published December 1 in JAMA: Internal Medicine.

Wound healing in patients with diabetic ulcers appears to be better with weekly applications of a dehydrated human amnion/chorion membrane allograft (EpiFix) compared with either a tissue-engineered skin substitute (Apligraf) or standard wound care, suggested a new randomized prospective trial published online in the International Wound Journal.

Benign paroxysmal positional vertigo (BPPV) is more common during seasons when vitamin D levels are low, suggests new research published online in JAMA Otolaryngology - Head & Neck Surgery.

Inflammatory bowel disease (IBD) seems to be an independent risk factor for developing catheter-associated deep venous thrombosis (DVT), suggests a review published in the December issue of Diseases of the Colon & Rectum.

A new study supports current recommendations to treat HIV-infected adults with early syphilis with a single dose of benzathine penicillin G (BPG) rather than multiple doses. The report is published online in Clinical Infectious Diseases.

IMA News

Debate: Dental Council proposes three-year bridge course in MBBS for BDS graduates: Friday, November 28, 2014 : The Hindu: Mangalore: The Dental Council of India is proposing a three-year bridge course in MBBS for BDS graduates in a bid to enable them to provide both medical and oral healthcare in rural areas.

Dr Dibyendu Mazumdar, president, Dental Council of India, said, “There is a shortage of medical professionals in rural areas. A good number of BDS graduates come out every year. These graduates have already been trained in many aspects of treatment during their five-year course. With a further three-year MBBS course these graduates can meet the requirement of medical professionals in rural areas.”

DCI vice president Dr Y Bharath Shetty said, “The curriculum (of the bridge course) will be framed and passed in the general body of the DCI before submitting it to the government.”

66th Annual Conference of Cardiological Society of India (CSI) -2014

Dr KK Spiritual Blog

Are We Honest?

Most of us are relatively honest. If I introspect myself, I consider myself as an honest doctor but when I go deep into introspection, I see that I am only relatively honest. I used to give money to the TT to get a reservation in a train, buy a cinema ticket in black, pay money to the electrician to get my electricity in time during function etc. etc.

Corruption is corruption whether it is for one rupee or 1 lakh rupee. Many of the current so called anti-corruption campaigners have purchased their houses by paying in black. Accepting donations from people who are not honest and from people who are donating from their unaccounted money is also corruption.

Only corrupt people approach a corrupt person and therefore for him every one is corrupt. The vice versa is also true.

Inspirational Story

Begin with a Blank Page

If you could start your life all over what would be different? What would you change now if you were able to wave a magic wand and start from scratch? Just imagine you have no ties, no burdens, no limits, no memories, and no past.

What would your life look like? If the answer that comes to your mind is different than what you are doing, why is that? Is it because of someone else's opinion? A spouse, a parent or maybe your children?

The ultimate test of your life is to close your eyes and think of yourself on your deathbed. Lying there, preparing yourself to leave, look back at your life as you are currently living it.

How do you feel? Are you satisfied you lived completely? Or do you wish you had done differently? Very few of our senior citizens look back on their life and say, "I sure wish I had spent more time at the office!" Nobody says, "I wish I had watched more TV!"

This is what they say. "I wish I had been bolder. I wish I had given more. I wish I had tried harder to see more, do more and feel more." People wish that they had lived more. I, for one, have to admit to a certain amount of holding back on dreams and goals because of our two boys. As my life progresses I realize there is no reason to hold back.

We have not been exactly standing still either. We have done our best to live our dreams. We built a sailboat and sailed for 7 years traveling on the open ocean. We lived in the snow in Aspen Colorado, and on the beach in South Carolina. An old brick mill was our home in Long Island, versus a boat dock in Palm Beach Florida. We are writers of books and music, actors in the theater, and we home- school the boys. We have built a horse farm, and businesses! Yet, there is so much more we want to do!

It is a balancing act. We all must have sufficient finances to support a comfortable lifestyle, (although most of us tend to spend way too much on that!) Part of this balancing act is understanding what we are passionate about doing so that work becomes a joy instead of a job. Is this not a major reason of lost dreams and goals? Many people find work, call it a job and make a living at it. But they begrudge every minute of it, going as far as using the job as a reason for playing the martyr. Find something else!

There are many, many teachers of the attraction philosophies of "making a life". With as many opportunities today in every field imaginable, somewhere, something is calling to you.

Another part of the balancing act is to include those around you in frank and open discussions in what it is you want. I find some of my coaching clients have kept their wants and needs bottled up inside them forever! They had already decided for the other person in their lives there was no interest in whatever it was they themselves wanted to do! How absurd! How can we possibly know what someone else wants!

Would it not be tragic to spend your life in a big city for 40 years, working at a job you despise because you thought your spouse liked it, even though you wanted to live in the country and be a farmer? Then one day you overhear your spouse tell her best friend all she ever wanted to do was live in the country? 40 years! Sure this is a bit farfetched - but you would be amazed at what I hear!

Make an attempt today to start with a brand new page of your life. Create your life story how you want it. If there are others in your life to be involved, have them do the same exercise. Then compare what your notes. If this matches your current life, congratulations! You are one of the few. Now make it better.

However, if your written life stories sound like someone completely different, then you are living a life of conflict. Here is the good news. Your life is your life. No one can take that away from you. You are not indentured. You are not a slave. You are free to go, do, and be whomever you wish.

It might not be easy, but it sure might be worth it. I coach people daily who are changing their lives. There are so many things to be grateful for, and so many things open to us. We owe it to all the ones before us who gave us this opportunity to take advantage of it.

Worldwide, the most common cause by far of human rabies infection is dog bite. The host animals of the rabies virus differ among regions, even though almost every mammal is capable of contracting rabies. The main vectors are foxes in Europe and Canada, raccoons, skunks, and fruit-eating and insectivorous bats in the United States, dogs in Asia, mongooses, jackals, and dogs in Africa, and dogs and vampire bats in Latin America.

In India, the animals commonly responsible for transmission of rabies are dogs and cats (97%) followed by wild animals like mongoose, foxes and jackals (2%) and occasionally by horses, donkeys, monkeys, cows, goats, sheep and pigs.

Cardiology eMedinewS

Heart rate variability appears to reflect levels of disease activity in patients with systemic lupus erythematosus, suggested new research presented at the American College of Rheumatology 2014 Annual Meeting.

By wearing a novel radiation-monitoring device that beeps faster and faster as radiation exposure increases, interventional cardiologists working in a cardiac catheterization laboratory could decrease their radiation exposure by a third, reported the RadiCure study presented recently at the American Heart Association (AHA) 2014 Scientific Sessions.

Pediatrics eMedinewS

Exclusively breast-fed newborns lost as much as 10% or more of their birth weight before beginning to gain again in the first days after birth, reported a recent study. By 48 hours, almost 5% of babies born vaginally and 10% of those born by cesarean delivery lost at least 10% of their birth weight. In an article published online December 1 in Pediatrics, researchers state that these metrics could help identify babies with steeper weight loss trajectories that could increase morbidity risk.

Growth hormone treatment increases muscle thickness and improves motor development in infants with Prader-Willi syndrome (PWS), suggests a new study published online in Pediatrics.

Quote of the Day

Assumptions are the termites of relationships. Henry Winkler

Wellness Blog

Have Leg Artery Blockages? Walk on a Treadmill

A planned program of walking is good for people with blockage of leg blood vessels called peripheral arterial disease (PAD).

Normally when there is pain in the calf muscles in the leg on walking, the usual tendency is to rest and not walk. A study of 156 people with PAD published in JAMA showed that regular six-minute walks on a treadmill improved their endurance and quality of life. The study examined patients with symptoms and without symptoms. Over the six months of the study, the participants who did their regular six-minute treadmill walks increased their walking distance by about 69 feet, while those who did not walk regularly saw a decrease of 49 feet.

There is the potential for greater oxygen extraction from the blood under maximum exercise conditions. The muscles can make better use of blood flow and the oxygen release that comes from it.

Such exercise leads to improvement in "collateral circulation" i.e. growth in the number of blood vessels supplying the legs. Clinicians should urge all PAD patients, whether or not they have symptoms, to engage in a regular, supervised exercise program.

Walking is a standard recommendation for people with PAD. A recommended regimen is a 40-minute walk three times a week for at least six months.

Persistent leg pain is an indication that help is needed. In the absence of that symptom, physicians can test for PAD by measuring the difference in blood pressure between an ankle and an arm.

The Sameer Malik Heart Care Foundation Fund is a one of its kind initiative by the Heart Care Foundation of India instituted in memory of Sameer Malik to ensure that no person dies of a heart disease because they cannot afford treatment. Any person can apply for the financial and technical assistance provided by the fund by calling on its helpline number +91 9958771177 or by filling the online form.

Situation: A 50–year–old male came with early morning onset of acidity.Dr. Bad: Take an antacid.Dr. Good: Get an ECG done.Lesson: Onset of acidity after the age of 40 unless proved otherwise is acute coronary event.

Make Sure

Situation: A patient of gross ascites presents with complaints of difficulty in breathing on lying down.Reaction: Oh my God! Why did you drain so much ascitic fluid?Lesson: Make sure, to evaluate the patient thoroughly and only moderately tap the ascitic fluid since overenthusiastic tapping can be life threatening.

eMedinewS Humor

Three Vampires Walk into a Bar

Three vampires walk into a bar and sit down at a table. The waitress comes over and asks the first vampire what he would like. The first vampire responds, "I vould like some blood." The waitress turns to the second vampire and asks what he would like. The vampire responds, "I vould like some blood." The waitress turns to the third vampire and asks what he would like. The vampire responds, "I vould like some plasma."

The waitress looks up and says, "Let me see if I have this order correct. You want two bloods and a blood light?"

Twitter of the Day

Dr KK Aggarwal: Do not ignore sore throat in childrenDr Deepak Chopra: Happiness for a reason is a form of misery. Happiness for no reason is bliss

ePress Release

Ebola cured patients are no threat to the people living with them

The recent case of an Ebola cured 26-year-oldpatient who was treated in Liberia and given a certificate of successful treatment by the Liberian health authorities has raised many concerns among the people in the country about the chances of getting infected with the virus if anyoneis living with the patient cured of Ebola. The 26-year-old man is however kept under isolation in the special health facility of Delhi airport.

Commenting on the issue of the contagiousness of infection from Ebola treated patient, Padma Shree Awardee, IMA General Secretary Elect, Dr. KK Aggarwal President Heart Care Foundation of Indiasaid, “Ebola patients who have been discharged from the hospital can rejoin their families and communities.CDC has advised that there is no public health concern after discharge.Discharge itself means that there are no traces of Ebola virus in the blood of the patient who is cured of the disease. However, this can be confirmed only after 2-blood check – ups in a 24 hours interval time. If after these tests, the results are negative then the patient poses no risk to the household contacts or to the public.”

Individuals who recover from Ebola are not contagious as far as transmitting the virus through close personal contact with blood or body fluids such as urine, feces, sweat, or vomit is concerned. However, they should avoid sexual relationship for 90 days after the illness has been cured completely.

One should not be reluctant to live with Ebola cured patients. Based on available evidence, Ebola survivors have not transmitted the virus to others after it is no longer present in their blood. There are no restrictions to the patients’ activities of daily living.

eMedi Quiz

Which one of the following is a recognized X-Ray feature of rheumatoid arthritis?